Why Is Healthcare Still A Trainwreck? Can It Be Fixed?

A tough topic with not easy solution, but we took a shot at it with Dean Clancy, a healthcare policy expert with Americans for Prosperity.

Episode Transcript

(00:08):
Well, good morning, Frands.It's a wet day and again a lot
of localized flooding in much of thebroadcast areas would be safe as you're driving.
Remember if you are in and aroundLeon County, your schools are gladed
by one hour across the board,high school, elementary, and middle school
all starting one hour later. Welcometo Thursday of the Morning Show with Preston

(00:29):
Scott. That is Grant. I'mPreston. Great to be with you April
eleventh. Appreciate you sharing time withus. We try to make the most
of it. And we have aguest here from the Americans for Prosperity Organization
and I've had guests with AFP fora while and Dean Clancy is the senior

(00:51):
Health Policy Fellow at AFP. Dean, welcome to the show. How are
you. Oh, it's great tobe here. Thank you. Let's talk
a little bit. You're expertise pieceis healthcare, and you know, in
fairness and it's really tough for meto be fair to the Biden administration because
the resident has been a disaster,but he he's inherited a mass that his

(01:14):
predecessors inherited, and his predecessors haveinherited. But let's first start talking about
Bidenomics. How is how's Joe madethings worse? Well, you know,
he's got an incredible record. Priceshave soared, it's harder to get groceries
and gasoline. The job market continuesto be iffy. A lot of people

(01:38):
have just stopped looking for jobs.There's been some improvements, but not nearly
what he boasts about. And whenit comes to healthcare, well, health
insurance premiums are at an all timehigh. It's getting harder to find a
doctor and a hospital that's in yourhealth insurance plans network. That's directly a

(01:59):
result of the so called Affordable CareAct that he called a big deal fourteen
years ago. And of course hehas no accomplishments to run on to speak
of on things like immigration, foreignpolicy, energy and so on. So
other than that, he has afantastic record. Bidenomics is working. Healthcare

(02:20):
though, as we said, isour focus. And what specifically has he
done that has been responsible for thecontinuing spiral of the healthcare cost problems in
this country, Well, he's doubleddown on an approach that predates biden which
where the government basically misregulates and oversubsidizes and missubsidizes healthcare so that prices just

(02:50):
always keep rising and almost always fasterthan inflation. And of course he supported
the Affordable Care Act. When hecame into office, he doubled down by
making those subsidies much more lavish.He's also imposed price controls on prescription drugs
in Medicare, which is very popular, but it's leading to drug shortages and
will stifle new cures. Economists acrossthe political spectrum agree about that. And

(03:16):
the other day he had an eventwith Senator Bernie Sanders where he tried to
tout all of this as a greataccomplishment. But at Americans for Prosperity,
we do a lot of polling.We talk to people on their front door,
and what we found is that thehigh cost of healthcare is now the
number three issue on their list,exceeded only by inflation and jobs. That's

(03:39):
where we are with Bidenomics and Biden'shealthcare record. I'm surprised that immigration is
not on top of that, Butlet's set that aside for a second.
Dean, how do we reset things? You know, I mean, it's
easy for us, and it's quitehonestly, it's low hanging fruit to dump

(04:02):
this on Biden. He deserves blamefor his portion of this. But the
problems with healthcare in this country predateJoe, They predate Obama, They predate
a lot of things. Where policyanalysts have experts found where healthcare got off
the rails, Yes, yes theyhave. And by the way, on

(04:25):
immigration, you're right it is numberfour. Both healthcare and immigration are in
the top five consistently throughout this presidencyas a concern of voters. Where did
we get off the rails? Well, it actually goes all the way back
to World War Two, when thefederal government, under pressure from labor unions
during wage and price controls, decidedto just not tax employer provided health benefits

(04:50):
even though they are a form ofcompensation they technically should be taxed as income.
When they did that, it drovea movement to everybody g group health
insurance instead of just purchasing you know, individual health insurance, you know,
directly from an insurance company. Andwhat that did was set off an inflation

(05:11):
because people relied a little too muchon insurance, and so they've become disconnected
from the price. They don't askhow much will this cost? In nineteen
sixty, about half of our expenseswere paid for out of pocket in medical
care. The Morning Show with PrestonScott on News Radio one hundred point sevenfla

(05:39):
shared earlier in the program of afriend of mine who was being asked to
pay thirty three thousand dollars a monthfor a five month course of a medicine
to treaty condition. And I don'tknow where you come up with one hundred
and sixty five thousand dollars to payfor a Pfizer drug like that, Dean

(06:01):
Clancy with us from Americans for Prosperity. Dean. That's one example, and
there's countless others just like it.I don't even know where to begin.
Sure, some prescription drugs are veryexpensive. Part of that is because they're
new, they're breakthroughs, and there'sa patent a monopoly granted by the government,

(06:24):
and that helps the drug maker ofthe inventor recoup their costs of research
and development. But those drug companiesdo play games to try to prolong those
monopolies, and the government has distortedthings so badly that the prices can be
ridiculous. The good news is mostprescription drugs in America are actually rather affordable.

(06:46):
It's largely a success story. Butpeople who do see those outlier drugs
that cost so much. That causesa political problem and the result has been
caused by politicians for price controls.At AFP, we think that's a mistake.
We should try to have more competitionto drive down drug prices, not
more government. See I would seein this one case, I would say,

(07:11):
you know, shame on the doctor. I mean, you know,
a person can't afford that, andso why even put that out there.
If the person cannot afford that typeof medication, go with another treatment,
go with a different set of protocols. Well, sure, if there is
an alternative. It may be thatthere is none. And of course this
is precisely why people have health insurance, is to deal with large unexpected expenses

(07:39):
like the one we're talking about,and people need that. But unfortunately the
government has basically driven up the costof insurance for everybody, and it doesn't
need to be that way. Itwould be much better if you know,
we don't need to take away subsidiesfor health insurance. And by the way,
almost all Americans receive some kind ofsubsidy. It could be directly through
a government program or indirect through thetax code. But we all get some

(08:01):
money. Why not let people takethat money directly as cash basically that they
can use for the health insurance theywant, the amount of coverage they want,
and then what they don't spend oninsurance, let them save that in
a tax advantaged health savings account whichthey can use for their copays, deductibles,
prescription drugs, doctor's appointments, youname it. This is very easily

(08:24):
doable, and if we did it, I think you would see costs coming
down because we would have more youknow, more people shopping for value,
demanding price transparency, more competition,you know, what makes markets work in
every other part of the economy besideshealthcare. You know, one of the
things that strikes me as we're discussingabout this, Dean, is that you're

(08:46):
starting to then untangle the web,and you start to see how broad the
web is. For example, thisreally involves tax code. You know when
you said earlier that the benefit shouldbe taxed, well, certainly not under
the tax code we have right now. And so you then have to address
tax code. And we even wehaven't even gotten to tort reform and the

(09:07):
need to go there to address this, and so I just wonder what the
practical ramifications are of fixing this andwhether it can be fixed. Bear with
me, we're gonna take one morebreak. Here with me is Dean Clancy.
These are the Americans for Prosperities,the senior health policy fellow there.
We're talking about healthcare in America.Bid Noomics, of course, has been

(09:28):
a disaster across the board. It'sonly exasperated the problem or exacerbated the problem
with health care costs. But itpredated Joe, it predated Barack Obama and
the foolishness of the Obamacare that theSupreme Court unbelievably codified. You know,

(09:52):
this is a massive problem, andunpacking it is going to be very difficult.
We'll get to a little bit morewith Dean next. Apologies if I
sound scattered. I think it's thenature of climbing the mountain, the mountain

(10:13):
of the healthcare challenges that this countryfaces. You know, I talked earlier
about the fact that and Dean Clancywith us from Americans for Prosperity. Dean,
I just mentioned the misnomer of theword insurance in and of itself,
that If you force insurance companies tocover people with pre existing conditions, that's
no longer insurance. If we wantto do it, that's fine, but

(10:35):
let's call it something else, becauseinsurance is about managing risk, and so
to a certain extent, we havesome semantic problems to add on top of
everything else. No, you're right, we call it insurance, but it's
really prepaid health benefits, and it'snot insurance. True insurance, you're right,
is based on risk. And whenyou do it that way, healthy
people have an incentive to sign upearly and to stay enrolled in the insurance.

(10:58):
Risk, which is good for everybody, brings prices down. We've messed
that up with government policies that basicallyturn insurance into a political benefit. That
you know, it's all about mandatesand price controls, and it is a
mess in your mind. Give usthe three things that you think need to

(11:18):
be done in order in order forus to get a movement of this going
in the right direction. With regardto healthcare, well, the one big
thing we need to do is whatwe at AFP call a personal option.
That's a personal option means reforming healthcareto put you, the patient in charge.

(11:39):
And the three big components of thatare first, fund patients, not
insurance companies. We've got billions goingto insurance companies through Obamacare, Medicaid and
other programs. Let's let individuals takethat money and take control and spend it
themselves on the insurance they want.The second plank is let everyone have a

(12:03):
tax free health savings account, sothey can spend what they don't you know,
those subsidies, whatever they don't spendon insurance, they can put it
in the account, and they canbuy the medical services and see the doctors
for example, that their insurance doesn'tcover, you know, with them in
control. So hsays for all.And then the third thing is let everybody
have the option of paying for healthcaredirectly, you know, instead of going

(12:28):
through insurance. Just pay your doctorsdirectly, maybe on a monthly subscription basis.
This is a movement right now.They call it direct primary care.
You pay a fixed fee every month, no extra fees, and your doctor
is available to you essentially around theclock. It's great. Patients love it
and doctors love it because they're practicingmedicine instead of working for insurance companies.

(12:50):
So those are the three planks.Of the personal option obviously part of that
with at least two of them.Best as I can tell, would be
the requirement for us to know whatcertain procedures a menu of prices for services
right well, and you would getthat, You would get price transparency,

(13:13):
would you would see shoppable services upfront? Right now? Healthcare is like
a grocery store where there's no priceson the shelves and some of the aisles
you're not allowed to do unless youget permission from your health insurance company,
and you might find your grocery storeis not even in your health insurance network.
You know, it's crazy. Whereaswith the personal option, it'll be

(13:35):
like today's grocery stores. You'll seethe prices and the products upfront, and
you'll decide what you get and howmuch you get. And it'll work because
markets work, even in healthcare.Dean in closing, what are the biggest
impediments to this? Are they ingovernment or are they in the healthcare provider

(13:56):
the insurance provider sector. The biggestopposition is all the special interests that are
making a mint off the status quo. That's health insurance companies, pharmaceutical manufacturers,
you know, doctors, hospitals.They're all kind of we're all victims
of a system that has become veryhard to reform. But the hope is

(14:20):
that if enough voters can let politiciansknow that they're demanding change. I do
think you can get change. Itwill be incremental, but move in the
right direction. The other big problemis healthcare politics is highly polarized, with
Democrats favoring government solutions Republicans favoring marketsolutions, but it's been hard for them

(14:41):
to find centrist incremental solutions. Wethink the personal option is exactly that it
shouldn't be controversial, and we've beenworking to line up support in Congress.
We've actually got several hundred members ofCongress now who have put their name on
one or more of these personal optionreforms that I'm talking about. And if
we can just get the right personin the White House and the right people

(15:03):
controlling Congress, I think we havea chance to move forward and make health
care better. Dean, thanks forthe time today. I appreciate you bringing
some clarity to what is an absolutelymuddy situation. Thank you for your time.
Oh it was my pleasure. Thankyou. Dean Clancy with US Americans
for prosperity my guest. He isthe Senior Health Policy Fellow with AFP.

(15:28):
Interesting set of potential solutions. Theresomething to think about. Twenty seven past the hour